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NPI Code Detail

MEDICARE: DR. EMELIO L. D. WOODSTOCK

MEDICARE: DR. EMELIO L. D. WOODSTOCK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianA188573CA

General Provider Information

NPI Number : 1033858048
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMELIO L. D. WOODSTOCK
Provider Business Mailing Address
First Line : 616 S KENMORE AVE APT 406
Second Line :
City : LOS ANGELES
State : CA
Zip : 90005-2684
Country : US
Telephone Number : 347-852-1800
Fax Number :
Provider Business Practice Location Address
First Line : 4650 W SUNSET BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-6062
Country : US
Telephone Number : 323-660-2450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2022
Last Update Date : 01/05/2026

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